Five people—three of whom Armenian—were indicted in the US in a federal medical insurance fraud case that claims two San Fernando Valley clinics were used as fronts in a scheme to net $8 million in false claims, according to Los Angeles Daily News.
The indictment claimed Roshanak Khadem, 50, with the help of another defendant, Gary Jizmejian, 44, devised a scheme in which they would give patients free cosmetic procedures in exchange for their insurance information.
The defendants who worked at the clinics would then fraudulently bill insurers for covered medical procedures. In return, patients would get a calculated credit for free or discounted for future work at the clinics, the indictment said.
The indictment described Jizmejian as a former senior investigator for the Anthem Special Investigations Unit, an internal anti-fraud investigation unit for the insurer.
While working at Anthem, Jizmejian supplied Khadem with confidential information about the insurance company, and how to evade fraud inquiries, the government said.
Jizmejian also diverted other Anthem investigators away from looking at the clinics and the doctors recruited to work at them, the indictment said.
Also named in the indictment as defendants were Marina Sarkisyan, 49, office manager of the clinics; and Lucine Ilangezyan, 38, an insurance biller for the clinics, the indictment said.
From 2012 to 2017, the defendants billed insurance companies a total of $20 million in false claims, and got back $8 million, the indictment said.
All the defendants are charged with one count of conspiracy to commit health care fraud, plus 13 counts of health care fraud. Each count carries a possible maximum of 10 years in prison, and the indictment also seeks forfeiture of gains made in the alleged scheme.